Category: Before Cataract Surgery

Your decision to undergo cataract surgery is the major step towards your visual improvement and cataract treatment goal. Normally at home one has best opportunity to have a well focused preparation before surgery.

The journey to better vision begins…… right from the pre-operative office visit through consultation till ultimately your vision goal is obtained. We assure our support in this endeavor.

Preparation for cataract surgery:

Instructions before cataract surgery:

Eye care

The eye is required to be kept clean and infection free.

Instructions regarding the instillation of eye drops are to be followed.

Advisable to maintain a gap of 5 minutes between two types of eye drops on instillation.

Contact lens in the affected eye is needed to be removed before the surgery to prevent infection.

The contact lens removal duration also depends on the type of contact lens used.

Rest

Avoid straining the eye.

Unprotected UV rays to be avoided. Use UV protected sunglasses while out in the sun.

Take ample rest before surgery.

Diet

Have healthy and wholesome diet.

Relaxation

Keep yourself stress free and without anxiety.

Medications:

Follow medications as instructed.

General Hygiene

Follow general hygiene in handling eye drops. Hands to be washed well before and after application.

Transportation arrangement: To and fro travel arrangements to be made being an outpatient procedure.

On the day of cataract surgery:

Ensure medicines are continued as instructed and medicines which need to be stopped are discontinued. Do not stop any medication without advice.

Maintain required hygiene conditions favorable for the surgery.

Fasting before surgery- You may be asked to avoid any solid food 3 hrs before the surgery/ liquid foods 2 hrs before surgery unless instructed otherwise.

Avoid smoking or alcohol.

Carry all medication details and reports.

In case of contact lenses, they should not be worn on the day of cataract surgery.

Having head bath in the morning of the day of the surgery is advisable.

Avoid eye makeup especially on surgery day.

Ensure arrangement is made for relative / by stander to accompany you for the surgery.

In case of diabetic patients, the instructions need to be followed accordingly.

Use comfortable clothing on surgery day.

Ensure you reach the hospital in time.

Normally tropical anesthetic eye drops are administered, do inform in case you have any allergies to anesthetic drops or any medicine in particular.

In case you are affected by other eye conditions like Glaucoma or previous eye surgery, kindly follow instructions as recommended.

Proper understanding and follow up of pre- operative instructions streamlines the process of your treatment and helps you to make the best of your time at home before the cataract surgery. You could refer to the printed copy of the pre-operative instructions for guidelines and cross reference. Nevertheless in case of any further queries, do contact us. We would be glad to assist you.

Medications for eye: Eye drops as prescribed which need to be started before reaching the surgical facility to be followed as advised. These are usually dilating eye drops to ensure that the pupil is dilated for the surgery. These may be repeated after admission.

Other medications: Medications for Diabetes, Thyroid and high blood pressure etc. should be taken in the morning as usual, with your light breakfast.Oral antibiotics may also be started the day before surgery.

By stander: You are advised to be accompanied with a family member/friend from your home till you reach back home after the surgery is completed.

Travel arrangement: Ensure appropriate arrangement is made to travel back home. It is not advisable to drive back by yourself as your operated eye is protected by a shield and vision would need time and rest to restore back.

Fasting:If the surgery is under general anesthesia (as in case for children) then overnight fasting as instructed to be followed. Otherwise a light breakfast is recommended.

Physical preparation for the surgery: Ensure you are free from illness on the surgery day. In case you happen to have any other discomfort, cold, cough fever or high BP. Kindly report the same to the nurse/ doctor.

Mental preparation for the surgery: Although cataract surgery is the most common procedure, for most people cataract surgery may be is their first eye surgery. In case of adults it is quite possible that some do have a phobia for operations due to past experiences of other surgeries. In case of any such issue, do inform us to ensure that we help you relax before surgery. At Shroff Eye Hospital, we encourage you to be well prepared not only physically but also mentally through various consultations including our counseling session. Moreover your meeting with our operating surgeon would have already helped you gain confidence for the surgery.

Finally, you need to reach the surgical facility in time with all relevant documents.

Steps before the cataract surgery at the surgical centre:

Irrespective of the type of cataract surgery to be performed, Noted below are the common processes that follow prior to surgery:

You would be greeted and welcomed by our nurse at the time of admission.

She would escort you to your day bed and orient you to the room facility and other details like the emergency bell, rest room area etc.

You would be given a change of clothes for the surgery.

The nurse would review your medical history. You would be asked a few questions regarding your medications etc.

Your vital parameters such as Pulse, Blood Pressure, Oxygen saturation would be checked and noted before the surgery. This is to ensure parameters are within the normal level.

Diabetic patients may require to be tested with a spot test for blood glucose level to check control of blood sugar.

Dilating drops for cataract surgery will be continued as required.

A skin test is done for checking any allergy / sensitivity towards the anesthetic agent.

With the continuous support from our entire team, you could be assured of best care at the surgical facility before the operation.

After completion of your initial eye examination and consultation with us, we guide you in your decision on when you need to have a cataract surgery. Cataract surgery being an elective procedure, the time for the procedure is mutually discussed; however the final decision lies with you.

Understanding the symptoms, risks and treatment of cataract helps in taking the decision for cataract surgery.

With a wide array of intraocular lenses to choose from, it could be a difficult decision. Our advise during consultation helps you to make the right choice depends on your need, life style and eye condition.

With the expertise of our well experienced surgeons you could have an enhanced surgical experience.

A common myth regarding cataracts is that cataracts need to be mature enough for surgery. This may not be required with the latest advances in cataract surgery. Moreover cataracts are likely to harden as stages advance leading to more complications during surgical removal and also higher risk of other issues like glaucoma or other age related complications etc.

Symptoms and Indication:

Deterioration of vision may not always be an indicator for cataract surgery. For example: Although vision may be 20/20 still cataract surgery may be required. Some for work conditions that require fine vision, even glare could affect their vision.eg. Pilot, Drivers etc. Nevertheless any symptoms of cataract like blurred vision, halos or glare etc. should not be ignored. Intervention and treatment at right time is important.

Decreased vision and quality of life:

Cataracts disrupt your quality of life. Cataracts need treatment anyway; the only treatment being a surgery. There is no advantage of postponing treatment because delay can worsen the cataract. Moreover as age progresses other aliments like diabetes or heart related issues could make surgery complicated and risky. The risks of accidents would be much higher without treatment. Furthermore you are restrained from doing the work that you want to do because of the decrease in vision. In case of cataracts that cannot be operated upon or those that do not need immediate surgical intervention, our surgeon and other option would advise other options and the roadmap of treatment.

If both the eyes require surgery, it is advisable to maintain a time gap between the surgeries before proceeding with the second eye. Usually a week’s gap is acceptable. This is to avoid infection and giving time to the first eye to heal comfortably. During your consultation you could get your doubts clarified in order to have a proper understanding of your treatment process.

Get rid of glasses: Decrease in vision is often corrected with corrective glasses. Today, cataract surgery can aid in getting rid of glasses as well. According to the type of lens used, one can opt for lenses which give you an advantage of being able to see near, intermediate and distant vision clearly, without need of glasses. These are multifocal or accommodative lenses. This enables you to get rid of cataract as well as be least dependent on glasses.

As the symptoms and eye conditions differ from each eye, the treatment options and guidance from eye specialists is vital.

Consultation at the right time would help you to take the right decision on your cataract surgery.

Cataracts can be detected and treated at an early stage. In some cases the clouding could be advanced and can be visible to even the naked eye, but in most of the cases, changes in the eye may not be visible without and internal eye examination by an ophthalmologist. In some case the symptoms are not major. Is it advisable to wait for recovery without a proper eye examination and treatment?

Regular eye examinations are important and the cost of the examination varies according to the tests conducted.

Why is an initial examination for cataract necessary?

To confirm the presence of cataract.

Rule out other eye illnesses which have symptoms similar to that of cataract.

Understand the stage of cataract and finalize on the treatment options.

Preparation for an effective initial eye examination:

During the eye examination the eye needs to be dilated for an accurate diagnosis.

Tests are normally conducted before and after dilation. You need to inform the optometrist if you have allergy to any medicines/ eye drops.

Understand the symptoms of cataract or other major illnesses if any and discuss them during the consultation.

Avoid self driving after eye dilation, as vision is blurred for a few hours.

Discontinue use of contact lenses, if using any, at least 24 hours prior to the examination.

Comprehensive Eye Examination

Comprehensive Eye Examination is conducted by both Optometrist and Ophthalmologist to determine the type, location and stage of the cataract.

Examination by Optometrist

Detailed history and physical examination of the eyes are reviewed.

Visual Acuity Test– The impairment in the vision is detected by reading the Snellen eye chart with variation in the size of letters and is read from various distances.

Refraction Test- It determines the need for changes in your eyeglass or contact lens prescription.

Tonometry test for Glaucoma screening– This is a standard test to measure fluid pressure (Intra Ocular Pressure) inside the eye. It is commonly known as the ‘Puff Test’. This test helps to exclude Glaucoma (condition with raised eye pressure) before the cataract surgery.

Pupil Dilation: The pupils are widened using dilating drops and a retinal examination is performed.

Examination with Ophthalmologist

Slit Lamp examination: The slit lamp has a special microscope for an eye examination. The structure in front and back of the eye including the cornea, iris, sclera, conjunctiva, lens, retina and optic nerve and the spaces in between are illuminated using a slit lamp to investigate minute abnormalities. A camera on the slit lamp stores the images as required. The examination takes few minutes and is painless. Special preparation is not required for the test. The thin beam of high intensity light on the eye gets a clear view of the internal parts of the eye. The examination is performed under dilation using eye drops. Based on the examination the further treatment is done.

Fundus Examination for retina:The fundus is part of the retina at the posterior part of your eye. In the fundus examination the pupil is dilated to increase the size of your pupil. The observation of the vitreous, optic nerve, blood vessels, macula and retina is then recorded. Here the retina is checked using an ophthalmoscope.

To avoid complication and have a successful cataract surgery the initial examination plays an important role in the diagnosis and treatment process.

Our ophthalmologist will guide you to the most suitable treatment and choice of lens based on the initial examination.

The pre-operative hospital visit is the next step after deciding on the cataract surgery in order to plan your surgery to maximize surgical outcome.

Why is a pre-operative office visit necessary?

This instills a level of confidence and preparedness for your cataract surgery.

Ensures an affirmation of your interest for the surgery.

A complete pre-operative assessment prior to the cataract surgery to ascertain your fitness for the surgery.

Opportunity to understand the diagnosis and the type of procedure advised.

To have a proper understanding on the entire surgical process and utilize the opportunity to clarify your doubts.

What to expect during your the pre –operative office visit?

Pre Operative Tests: The tests are common for all cataract patients while some tests could be specific as per your health condition to avoid any risk. All the pre-operative tests are conducted in the hospital.

Testing specific for the Intra ocular lens Implant called ‘A Scan’ is done by our optometrist to determine the powerr calculation of the intraocular lenses to be implanted. Depending on your needs, lifestyle and eye condition the type of lens could be decided with our guidance.

Laboratory tests and ECG normally lasting for20 mins approx. could be easily conducted in our in-house laboratory in the same hospital itself.

Fitness from our anaesthetist or your physician is required in case Blood Sugar etc are high or any reports are abnormal.

Medication:

You would be recommended to continue all medications for systemic conditions such as Thyroid Disorder, Hypertension, Heart Disease, Diabetes etc

Pre surgery antibiotics and some dilating eye drops to be used on the day of the surgery will also be prescribed to you, once you are found fit for the surgery with normal blood tests and ECG.

Pre – operative consultation:

This provides an opportunity to answer your queries about your cataract surgery and the precautions that need to be taken for the surgery.

You would be provided a hard copy on the details of the pre-operative instructions for planning your cataract surgery along with the consent form for cataract surgery. The form needed to be duly signed and accepted after understanding the risks, benefits and alternatives of the recommended type of cataract procedure.

How to make the best of the pre-operative office visit?

For clarity and better understanding at times you have be asked the questions on your health condition in detail or specific to a particular illness like diabetes or hypertension. Advisable to carry previous illness records and details of medications in use in case required. In some cases certain medications that may affect the surgery would be asked to discontinue on case to case basis.

Successful one to one communication is a key to utilize the purpose of the visit.

Advisable to be accompanied by spouse/close relative/friend for a pre-operative visit. This helps in ensuring that the instructions and recommendations are righty noted.

Correct method and proper administration of the eye drops prescribed.

Maintain good general health before and after the cataract surgery.

In case of any reasons you are unable to make the pre operative visit or you are suffering from cough, fever, BP etc., do let our office know so that we would assist in rescheduling the same.

WE ENSURE YOU HAVE AN ENRICHED AND SATISYING PRE-OPERATIVE VISIT FOR A SUCCESSFUL CATARACT SURGERY.

After completion of your initial eye examination and consultation with us, we guide you in your decision on when you need to have a cataract surgery. Cataract surgery being an elective procedure, the time for the procedure is mutually discussed; however the final decision lies with you.

Understanding the symptoms, risks and treatment of cataract helps in taking the decision for cataract surgery.

With a wide array of intraocular lenses to choose from, it could be a difficult decision. Our advise during consultation helps you to make the right choice depends on your need, life style and eye condition.

With the expertise of our well experienced surgeons you could have an enhanced surgical experience.

A common myth regarding cataracts is that cataracts need to be mature enough for surgery. This may not be required with the latest advances in cataract surgery. Moreover cataracts are likely to harden as stages advance leading to more complications during surgical removal and also higher risk of other issues like glaucoma or other age related complications etc.

Symptoms and Indication:

Deterioration of vision may not always be an indicator for cataract surgery. For example: Although vision may be 20/20 still cataract surgery may be required. Some for work conditions that require fine vision, even glare could affect their vision.eg. Pilot, Drivers etc. Nevertheless any symptoms of cataract like blurred vision, halos or glare etc. should not be ignored. Intervention and treatment at right time is important.

Decreased vision and quality of life:

Cataracts disrupt your quality of life. Cataracts need treatment anyway; the only treatment being a surgery. There is no advantage of postponing treatment because delay can worsen the cataract. Moreover as age progresses other aliments like diabetes or heart related issues could make surgery complicated and risky. The risks of accidents would be much higher without treatment. Furthermore you are restrained from doing the work that you want to do because of the decrease in vision. In case of cataracts that cannot be operated upon or those that do not need immediate surgical intervention, our surgeon would advise other options and the roadmap of treatment.

If both the eyes require surgery, it is advisable to maintain a time gap between the surgeries before proceeding with the second eye. Usually a week’s gap is acceptable. This is to avoid infection and giving time to the first eye to heal comfortably. During your consultation you could get your doubts clarified in order to have a proper understanding of your treatment process.

Get rid of glasses: Decrease in vision is often corrected with corrective glasses. Today, cataract surgery can aid in getting rid of glasses as well. According to the type of lens used, one can opt for lenses which give you an advantage of being able to see near, intermediate and distant vision clearly, without need of glasses. These are multifocal or accommodative lenses. This enables you to get rid of cataract as well as be least dependent on glasses.

As the symptoms and eye conditions differ from each eye, the treatment options and guidance from eye specialists is vital.

Consultation at the right time would help you to take the right decision on your cataract surgery.

Whenever one wishes to avail any kind of service, ultimately it’s the inherent value based factors rather than cost based that influence one’s decision to finalize and choose the right service provider from two or more identical vendors. In a cataract surgery, cost is an important factor in choosing the right hospital for surgery. Does the cost really matter for sight? Is the price a cost based pricing or a value based pricing? Does the cost incurred materialize to long term benefits like long term results? These are the questions that we normally introspect. Let’s understand more on the various aspects of costing in a cataract surgery.

The factors that determine the cost of cataract surgery:

Nature of procedure undertaken.

Type of lenses used.

Treatment of other eye conditions along with cataract surgery.

Locational advantage of the hospital.

Use of techniques involved.

Selection of an advanced technology upgrade.

Cost break up:

Cost structure in terms of the OPD fees which include the consultation, A scan fees and Lab test with ECG (pre operative blood tests).

Cost varies according to the type of lens used. Special lens like multifocal lens which takes care of far, near and immediate vision is priced accordingly at premium.

Apart from the above outstation patients would incur miscellaneous costs like the Cost of accommodation, travel, and other facilities.

Medical Insurance and reimbursement:

Certain type of cost in the cataract surgery are covered by medical insurance while others are not covered, hence one needs to be clear and well informed on the costing before the surgery takes place.eg Procedures that are considered cosmetic and medically unnecessary.

Selection of right lens:

We assist you in the selection of lens implant from a wide range of options according to the suitability. The cost variable will change accordingly with design, material, brand opted etc. If distance vision correction is made by IOL then glasses would be required to correct near vision. During the cataract surgery Presbyopia/ Astigmatism correcting lens could also be opted for spectacle freedom if recommended.

Type of cataract surgery and technology:

Not all cataracts would need surgery, a detailed discussion that benefits you would be advised and the best correction and treatment would follow with our advanced technology and surgical expertise. The cost overhead varies with the advancement in type of surgery performed and the technological platform operated.

Patient’s satisfaction and quality:

The terminology and the pros and cons of IOLs/surgeries would help in better understanding of the services and products used in relation with the incurring cost.

It is advisable to directly contact the hospital to discuss regarding the cost so as to avoid any confusion rather than following outside information or outdated data. Research, planning and control over the costing helps you in better financial management on the cataract surgery costs.

The overall quality of products used, care and services rendered does add value to your treatment.

For more details, do get in touch with us, for a cost effective surgery.

Cataracts are inevitable with aging and not completely preventable. Recent advancements in Cataract surgery have increased its safety, efficacy and success in many folds. This is the only effective treatment to remove cataracts and is vital for sight.

In a cataract surgery the cloudy cataract affected natural lens are replaced by artificial IOL depending on the suitability.

With present advancement in ophthalmology it is possible to detect cataract at an early stage and treat with best technology.

What happens if cataract surgery is not done in time?

Blindness: Initially cataracts may not be severe and may not affect vision. If left untreated cataract may progress and cause difficulties in vision and in rare cases it can lead to blindness.

Cause for other eye disorders: Cataracts can also lead to other eye disorders like glaucoma etc if untreated.

Complications: The surgery could get more complicated and risky in case of delay as the cataract tends to get dense and hard.

Advantages of a timely cataract surgery:

Spectacle Freedom: Cataract surgery the correction for Astigmatism and myopia can be made along with the cataract surgery and you could get spectacle independent in case you are a suitable candidate for the procedure. Cataract surgery previously had only a mono – focal lens implant option now with Multi – focal IOL technology can decrease dependence on glasses after surgery.

Helps to increase the quality life: Depending on your eye condition, nature of your job and your visual needs the right kind of surgery would be suggested to you so that you could enjoy best visual outcome. If delayed, there would be chances that make treatment more challenging with onset of other unforeseen diseases if any, e.g. heart or diabetes etc. In any case if surgery is unavoidable then procrastination could cause more harmful and affect your quality life.

Reduces the risk factor: A cataract surgery in time reduces the risk factor both for your eyes as well as overall health. Falling and accidents causing health hazards could be minimized as cataract blurs the vision.

Optimum visual results: Optimum visual results are possible with smaller incisions with new technology thereby faster recovery and better visual outcome. You need not be confined to the long rest time and have a painless, stitch less surgical experience. You could get back to your routine work faster depending on the type of surgery undergone.

Astigmatism correction: Corrections to resolve astigmatism could be conducted during the cataract surgery enabling you to have good distance vision without spectacles.

Insight for other eye illnesses undiagnosed: When you diagnosis for the cataracts we also look into the possibilities of other eye illnesses like AMD, if any through a comprehensive eye check up. Some conditions reducing visual potential like retinal scarring from macular degeneration, Floaters and other eye disease unrelated to cataract too be eventually treated and corrected.

A cataract surgery would mean entrusting your most precious sense organ of your body for surgery. A successful cataract surgery results in satisfying experience and best visual outcome.

In order to streamline your search on choosing a right cataract surgeon the aspects in the selection has been chalked out as below:

Aspects in selection of a Cataract surgeon

Yourself

Your surgeon

Your hospital

Yourself: The decision of choosing a right cataract surgeon for your eyes lies within you. In case you are unable to decide yourself, you need to consult your family members, friends, relatives, those specialized in the ophthalmic field etc. for opinion. It is also suggested to ask for reference from friends or relatives whom you trust.

Factors to be considered

Cost -The payment options need to work out for you. In some surgeries insurance is not applicable.

Research- Flashy advertisements may not expose the reality in terms of experience and skill. Before scheduling the consultation, the credentials need to be researched.

Your surgeon:

Factors to be considered

Experience- Cataract surgery is a microsurgery wherein a single wrong move could create a serious outcome. Successful outcomes are the fruits of vast time tested experience. Check on how experienced the surgeon is in his field of specialty.

Use of latest technology – Important aspect of consistent success is how the surgeon is able to adapt to the latest technology. Surgeon’s credentials including Training- Educational qualification, professional affiliations, state licensing, board certification etc. Check if the surgeon is a state licensed practitioner.

Total procedure performed- The total surgeries performed fine tune the expertise in the specialty. Check on the number of cataract surgeries done.

Skills – A skilled surgeon can handle any complex complications and emergencies.

Safety– Once the surgery is scheduled; your trust in the safety boosts your confidence. A good surgeon would conduct the surgery only if you are prepared and if you are the right candidate for the surgery. In case otherwise, for your safety the surgery could be postponed or cancelled. Your safety factor matters.

Your Hospital:

Surgical Team- Cataract surgery is a team work. Team knowledge also counts and capability of team also is important. An ideal hospital would have an excellent surgical team.

Facilities – Advancement in the usage right from the basic equipment is important as it aids in the refraction diagnosis, calculations and facilitates the better surgical outcome.

Post operative follow ups are conducted or not need to be checked. Good hospital simultaneously gives pre and post operative instructions for follow up.

Transparency in Information- Openness and transparency instills goodwill and confidence. E.g. Opportunity for your caretakers or family to see the surgery live on screen.

Professional environment.

Location advantage– Travelling for regular, follow ups and post operative check up are less tedious if centrally located by rail, road and air.

Hospital Reputation- It the goodwill created over years of commitment. Certifications of the hospital aids in distinguishing them from the other hospitals.

Choice of various surgical and IOL options should be available.

Media Reports- Media network and social network communications could also act as indicator in deciding the efficacy of the hospital.

Tips for choosing the right surgeon for cataract surgery

Find the complication rate & Infection Rate- Infection Rate also needs to be noted. Ideal hospital for cataract surgery would have the lowest rate.

Visit the surgeon or hospital website for more details.

Meet the surgeon face to face and discuss with past medical history.

Seek 2nd opinion if required.

Check online Testimonials for others experience.

A holistic evaluation before making your final decision in choosing the right cataract surgeon would benefit you; after all you have just a pair of eyes. The parameters to check on the criteria of selection in choosing the best cataract surgeon could vary from person to person.

Over decades, Shroff Eye Care is a pioneer ineye care built on trust and commitment to quality ophthalmic care for a lifetime.

During the cataract surgery the natural lens is removed and replaced with IOL (Intraocular lens) and vision is restored. The selection on the type of IOL will support the necessary correction to be implemented whether it is cataract, astigmatism or presbyopia etc. Apart from the correction another decision would be the need to use glasses or go spectacle independent.

What are the types of lenses and implants?

Some of the types of lenses and implants are.

Traditional lens Implant:

Monofocal lens: This is the most commonly used lens since decades. They are called Monofocal lens because they give the sharpest focus only one distance. Depending on which vision is selected i.e. (near or distant) glasses would be required. These lenses are suitable if you are willing to wear glasses. If you have set the monofocal lens for distance vision then for near vision glasses would be required and vice versa. It assists Monovision (one eye can be set for distance vision while the other eye takes care of the near vision). It does not correct Astigmatism and Presbyopia.

Premium lens Implant:

GOAL: Astigmatism correction.

Toric lens- Toric lens is primarily used in the correction of distance vision and near vision would still need glasses. This is another option to correct Astigmatism rather than making extra incision in your cornea.

GOAL : Presbyopia correction.

Multifocal lens – Multifocal lens aid in Presbyopia correction. They have varied power which makes one see at varied distances. Vision without glasses is possible although visual outcome varies from person to person.

If you do not have significant astigmatism and wish to have distance and near vision with limited intermediate vision needs then a multifocal IOL is best choice.